title: The coeruleus/subcoeruleus complex in rapid eye movement sleep behaviour disorders in Parkinson's disease.
abstract: In Parkinson's disease, rapid eye movement sleep behaviour disorder is an early non-dopaminergic syndrome with nocturnal violence and increased muscle tone during rapid eye movement sleep that can precede Parkinsonism by several years. The neuronal origin of rapid eye movement sleep behaviour disorder in Parkinson's disease is not precisely known; however, the locus subcoeruleus in the brainstem has been implicated as this structure blocks muscle tone during normal rapid eye movement sleep in animal models and can be damaged in Parkinson's disease. Here, we studied the integrity of the locus coeruleus/subcoeruleus complex in patients with Parkinson's disease using combined neuromelanin-sensitive, structural and diffusion magnetic resonance imaging approaches. We compared 24 patients with Parkinson's disease and rapid eye movement sleep behaviour disorder, 12 patients without rapid eye movement sleep behaviour disorder and 19 age- and gender-matched healthy volunteers. All subjects underwent clinical examination and characterization of rapid eye movement sleep using video-polysomnography and multimodal imaging at 3 T. Using neuromelanin-sensitive imaging, reduced signal intensity was evident in the locus coeruleus/subcoeruleus area in patients with Parkinson's disease that was more marked in patients with than those without rapid eye movement sleep behaviour disorder. Reduced signal intensity correlated with the percentage of abnormally increased muscle tone during rapid eye movement sleep. The results confirmed that this complex is affected in Parkinson's disease and showed a gradual relationship between damage to this structure, presumably the locus subcoeruleus, and abnormal muscle tone during rapid eye movement sleep, which is the cardinal marker of rapid eye movement sleep behaviour disorder. In longitudinal studies, the technique may also provide early markers of non-dopaminergic Parkinson's disease pathology to predict the occurrence of Parkinson's disease.
authors.affiliation: Institut du Cerveau et de Moelle épinière, Centre de Neuroimagerie de Recherche, Paris, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: García-Lorenzo
authors.forename: Clarisse
authors.initials: C
authors.lastname: Longo-Dos Santos
authors.forename: Claire
authors.initials: C
authors.lastname: Ewenczyk
authors.forename: Smaranda
authors.initials: S
authors.lastname: Leu-Semenescu
authors.forename: Cecile
authors.initials: C
authors.lastname: Gallea
authors.forename: Graziella
authors.initials: G
authors.lastname: Quattrocchi
authors.forename: Patricia
authors.initials: P
authors.lastname: Pita Lobo
authors.forename: Cyril
authors.initials: C
authors.lastname: Poupon
authors.forename: Habib
authors.initials: H
authors.lastname: Benali
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnulf
authors.forename: Marie
authors.initials: M
authors.lastname: Vidailhet
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lehericy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001931:Brain Mapping; D004569:Electroencephalography; D004576:Electromyography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008125:Locus Coeruleus / Q000378:metabolism / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008543:Melanins / Q000378:metabolism; D008875:Middle Aged; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000150:complications*; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000209:etiology* / Q000473:pathology*; D012044:Regression Analysis; D012189:Retrospective Studies; D014741:Video Recording; D055815:Young Adult
chemical_list: D008543:Melanins; C014121:neuromelanin
keywords: MRI; RBD; VBM; diffusion imaging; neuromelanin-sensitive imaging